Abstract
ObjectivesThe present study set out to investigate relations of the number of chronic diseases (as a global indicator of individuals’ multimorbidity) to cognitive status and cognitive decline over six years as measured by changes in Trail Making Test (TMT) completion time in old adults and whether those relations differed by key life course markers of cognitive reserve (education, occupation, and cognitively stimulating leisure activities). MethodWe analyzed data from 897 participants tested on TMT parts A and B in two waves six years apart. Mean age in the first wave was 74.33 years. Participants reported information on chronic diseases, education, occupation, and cognitively stimulating leisure activities. ResultsLatent change score modeling testing for moderation effects revealed that a larger number of chronic diseases significantly predicted stronger increase in TMT completion time (i.e., steeper cognitive performance decline). Notably, the detrimental relation of the number of chronic diseases to stronger increase in TMT completion time (i.e., cognitive performance decline) was significantly stronger in individuals with less engagement in cognitively stimulating leisure activities in midlife. DiscussionPresent data suggest that disease-related cognitive decline may be steeper in individuals who have accumulated less cognitive reserve in midlife. However, greater midlife activity engagement seemed to be associated with steeper cognitive decline in any case. Implications for current cognitive reserve and neuropsychological aging research are discussed.
Highlights
A major goal in current gerontological neuropsychology is to better understand how interindividual differences in cognitive health in old age emerge (Opdebeeck, Martyr, & Clare, 2016)
Objectives: The present study set out to investigate relations of the number of chronic diseases to cognitive status and cognitive decline over six years as measured by changes in Trail Making Test (TMT) completion time in old adults and whether those relations differed by key life course markers of cognitive reserve
To extend the literature we investigated relations of the number of chronic diseases to cognitive status and cognitive decline over six years as measured by changes in Trail Making Test (TMT) completion time and whether those relations differed by key life course markers of cognitive reserve
Summary
A major goal in current gerontological neuropsychology is to better understand how interindividual differences in cognitive health in old age emerge (Opdebeeck, Martyr, & Clare, 2016). With respect to an individual’s potential for preserving cognitive functioning in old age, the cognitive reserve concept postulates that lifelong experiences, including educational and occupational attainment, and leisure activities in later life, stimulate brain development which increases the reserve capacity that may compensate for brain damage, neurological loss, and pathological decline such as dementia (Stern, 2002, 2017). We further argue that because of their little reserves those vulnerable individuals have greater difficulty to deal with stressors that affect their cognitive functioning (such as suffering from chronic diseases). Less vulnerable individuals who have accumulated greater cognitive reserve over the life course should be able to better deal with the negative aftereffects of such stressors on cognitive functioning
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